12 practical steps to support children and young people who have experienced grief and loss - Calm Kid Central

Helping Kids with Worry, Anxiety and Stress - Parents and Carers

12 practical steps to support children and young people who have experienced grief and loss

Many children and teens have grief and loss experiences.  It has been estimated that up to 1 in 15 young people experience the death of a parent or sibling by the age of 16.  One study found 80% of 11-16 year olds report experiencing the death of a “close” family member or friend.  Many children also experience other significant losses – for instance the “loss” of the family unit through parental separation, sudden loss of a family home (house fire/disaster), the death of a pet, loss of some aspect of health/mobility, or the loss of a favourite or treasured activity or possession.

Here are some ways we can support our children and teens through grief and loss experiences.

1.      Information giving:  helping children and young people understand what has occurred and what will happen next

Children and young people often do not have knowledge or life experiences which help them understand a range of grief and loss situations.  For example:  unlike adults, often young children don’t always understand that death is irreversible and that a person/pet will not “come back”, or what to expect in a funeral service.  Children and young people may not understand what occurs when parents/caregivers divorce, how common illnesses are treated or managed and what emergency services workers do in times of crisis/flood/fires.

A simple way we can help young people who are grieving is to provide clear information about what has happened in their lives and what might happen next.   Children and young people will often not spontaneously ask questions or tell us what they are confused about – so sometimes we need to start these conversations ourselves.  Exactly how we do this will depend on the young person and the situation, but here are some examples of questions we can ask them to start these conversations:

Do you understand what has happened with X/to Y?
Do you want me to explain anything about X/Y/Z/?
Often young people don’t know what happens when X/in Y situation – would you like me to tell you what I know about this?
Is there anything you are feeling confused about?
Do you have any questions about what happens next/what has happened?

When we answer questions, we should try to avoid using adult jargon (“passed away”, “lost” or “gone to sleep”) and provide clear and specific information.  We can also ask for feedback about the information we provide (Does that make you feel more or less confused?  Do you have questions about what I have just said?).

Providing information and talking to young people about loss is of course more difficult if you are also experiencing the loss yourself.  Your own emotions can make it difficult to always be available to talk about the loss with your child, or your child may be hesitant in talking to you as they may not want to “upset you”.

It is important to let your child know that they can talk to you about how they’re feeling at any time and that you will do your best to answer any questions they may have. However, you may also want to identify other trusted adults or professionals that they can also go to for support outside the immediate family when needed.

2.      Help children and young people to notice and understand their (and others’) experiences of grief

When young people know their own (and their family members’) feelings and experiences are “normal” and related to grief they are less likely to be distressed and worried about having or noticing these experiences.  They are also often more able to be able to communicate them to others.

Here are a few ways we can help young people understand the feelings and reactions they might have.

“When someone dies/X happens/we lose something important to us, people have many different feelings like sadness, anger, worry, loneliness.  

People also sometimes feel guilty about things/relieved about other things or just feel numb.  

All of these feelings are normal and a way of our brains trying to cope with what has happened? 

Have you noticed any of these feelings?”  Have you noticed XX (ie me/your sister/someone else who experienced the loss) having any of these feelings?

“When someone dies/X happens/we lose something important to us, people have different things happen to their brains/bodies.  like having trouble thinking/remembering things/feeling sick/having headaches. Have you noticed any of these feelings?”

We can also use books and poems to provide information about normal grief reactions.  There are hundreds of books written to explain or explore grief concepts to and with children and adolescents.  A Google search for “children books grief” is a simple way of accessing a list.

As well as exploring and explaining concepts and inviting young people to “talk” about these feelings and experiences, we can also invite or set up ways of them expressing their experiences in ways which do not use language.   For example:

Would you like to use this (paper/clay/craft materials) to show me/others what it has been like for you?
Some kids/teens like to write a blog/story/poem/create videos about their story/experiences.  If you’d like to do that I could help by….
We could use these puppets/figurines to pretend they are…
Would you like to play this game AS IF…(acting out a situation)

Some young people want to and are able to talk/express/share easily and for longer periods of time, with a lot of detail– and others are not able or do not want to talk very much at all, and “shut down” a conversation very quickly.   Some research suggests girls are more likely to describe their grief emotions/experiences in more detail than boys, and both boys and girls who are more expressive and talkative in general (not surprisingly) are more likely to talk about their grief.

In general it is not true that the less a young person “talks” about their grief, the more problems they experience.  This means as adults it is important we invite children/young people to talk about their grief experiences but not to push for them to do so, or worry excessively when they do not.

One additional point on this topic:  many parents also worry about talking about or expressing their own grief in front of their children for fear of upsetting or scaring them. However, it can be reassuring to know that being open about your own grief can actually help your children to know that they are not alone in what they are feeling, and it models to them that it is okay to feel and express grief emotions in any way they need to.

3.      Understanding “normal” ranges of functioning during grief

Most people who experiences grief have periods of intense grief, and periods of time with less intense grief experiences.  Children and young people may have even greater variation between these episodes.

This means that grieving children and young people may have periods of time in which they laugh, play games, make jokes, want to see friends and react very similarly to how they did prior to the loss.  Some young people may feel guilty about this, so it is helpful let them know this is normal.  As a parent/caregiver, this can sometimes also be concerning or disturbing, as you may wonder if your child is “processing” the loss in helpful ways.

Please know that these periods of “regular functioning” are normal and both intense experiences of grief, as well as the periods of time in which they act/cope without showing grief, are healthy parts of the grief process.

4.      Provide reassurance about “secret” fears and sources of guilt

Many young people have fears and sources of guilt which they feel they cannot talk about in case of upsetting someone, or because of shame.  For example, they may believe they have done something to contribute to the loss, or are doing something to make things worse for family members.  They may be secretly afraid of further losses, or feel ashamed of some feelings they are experiencing in relation to the loss.

These secret fears and guilty feelings make young people feel worse.  We can help young people feel better by asking them about some common fears/sources of guilt and reassure them.  For example:

Some kids/teens are afraid that this will happen to them/happen again/happen to someone else.  Is that something which you think about?  Would you like to tell me about this?
Some people wonder whether it have been better if this happened to them.  Does that come into your head?
Some kids/teens think there are things about this which might have been their fault in some way?
Lots of kids/teens have other worries or things they feel guilty about thinking or saying.  Do you have any things like this in your head which you would like to share?

If you think your child may be more likely to confide in someone they see as “neutral” who is not so directly connected to the loss, it may be helpful to think of another adult they trust (or a counsellor/therapist) who they may be able to talk to.

Again, using other forms of communication other than talking can work better for some young people to help them express their fears/sources of guilt.  This might include drawing, text messages, or “acting out” concerns.

5.      Helping children find appropriate ways to remember and acknowledge their loss (or to make meaning from it)

Young people who are allowed to remember and talk about what they have lost usually adjust better to a loss than those who are discouraged from doing so.

This doesn’t mean we should push young people to do this – as stated above, some young people will be more open and able to share and express than others – but it does mean it is helpful to provide opportunities or space for this to happen.

Young people can remember, “honour” and talk about what has been lost in a variety of ways including:

Creation of and sharing/looking at photo books/photo boards
Space for conversations about the loss – eg asking children/young people about their favourite memories of who/what they have lost, or what they think someone would be doing/saying
Wearing special items of clothing/jewellery
Drawing pictures, creating videos, setting up social media/blog/digital accounts
Craft/clay/making of items to keep or share
Visits/outings to graves/sites of remembrance
Playing particular games/doing particular activities done “in memory”
Sharing memories (verbally, show and tell, stories/poems, pictures) with peers and classmates
Anniversary celebrations

For some young people, another way of remembering their loss is “making meaning” from it.  This might mean raising awareness of an issue, fund raising, sharing their experiences or learning about something related to the loss.

6.      Help children develop a plan for “waves” of intense grief

Like adults, children and young people have periods of time in which they experience grief more intensely.  These periods of time might be predictable (ie when they are reminded of their loss due to an event or situation in their life) or unpredictable (something minor might “trigger” a memory or thought about their loss).

We can help young people to know that “waves” of grief are normal, and also to help them generate a plan to help them cope through intense experiences of grief.

It can be helpful to do this in advance.  How we introduce the idea will of course vary according to age and situation, but some of the following sentences might be appropriate:

Usually when we are grieving, there are moments and times when we have a very strong sadness.  We can’t take these away, but we can have a plan for how to get through these.  Different people do different things to cope with those feelings.  Would you like to talk about what to do when these happen?

There are four different parts of a plan we can have.  We don’t have to have all of these, or any of these – they are just ideas.  The parts of the plan are: 1) things to do to keep our brain busy; 2) Ways to move our body and be physically active; 3) Ways to spend time remembering who/what we have lost, and 4) people to talk to or be with. 

7.      Help with managing tasks of daily lives

Young people who are managing grief, like adults, often find tasks of daily life – like socialising, chores, homework, paying attention at school, getting enough sleep, getting sufficient nutrition – more difficult to manage than before the loss.  This might be because their grief is making it harder for them to think and remember things, makes them more tired – or because other people or situations in their life have changed.

We can help young people by negotiating or adjusting expectations for a while.  We might need to ask specific questions about their routines and tasks.  For example:

Is there anything hard or tricky about this week?
What are the “small things” that just make things harder?
Is there anything in particular coming up which you feel is just too hard?

We then might be able to help young people in negotiations with teachers/schools, helping young people find the words to ask for help/share information with friends or do problem solving in other practical ways.

8.      Assisting with returning to routines and activities

In some situations, some young people might find it helpful to have “reduced expectations” for a time (less homework, sporting commitments or chores for example).   However it is usually helpful for children and young people to return to their routine and meaningful activities as soon as they feel ready.  Some young people want to do this very quickly – and this often worries adults who wonder if it is “too soon” or whether they need more time to “process” what has happened.  Generally holding a young person back from their regular activities is not helpful, so we need to be very careful about doing this.

On the other hand, some young people are reluctant to return to school and other activities for a longer periods of time.  In this case, we should again allow the young person to lead – however they may need some encouragement to try to be doing some regular activities for short periods of time, rather than have very extended periods of time away.

9.      Keep an eye on any unusual or severe symptoms or challenges

Most children who experience losses and grief (even those which seem very traumatic) do not go on to experience post mental health conditions.  However, a small minority do develop these conditions.  It can be helpful to keep an eye out for these changes in our children:

Deliberately avoiding – for a long time – anything related to their loss (keeping in mind as stated above that some avoidance is normal) even though this avoidance causes them problems
Using drugs and alcohol as a way of coping
Having frightening and ongoing “flashbacks” of something related to the loss
Feeling like there is no hope at all for change and/or feeling suicidal

If you notice these things developing, it may be important to seek support for them for a counsellor or other mental health professional.

10.  Provide hope and encouragement to young people

It is important for children’s well-being that they have hope for the future and they will look to us as adults to provide this.

It can be helpful to reassure young people that they (and people they love) can and will have meaningful lives doing things they care about – and will have many experiences of feeling love and joy – even despite experiencing loss.

You will always remember xxx/the time when we had xx.
We will always miss….sometimes.
But I also believe you/we will make a new life now that includes….
You will have many times in the future when you are feeling happy about your life.

11.  Help children and young people have support over the long term

Even young people who are generally coping very well after a loss are likely to experience some grief experiences (which may be small or intense) long after their loss.

In part this is because young people experience much more change and new events in their lives than adults.  For example, children who experience a loss in primary school will start high school, getting a new job, start new relationships and so on – all after their loss.

These new life events often trigger new grief reactions as young people realise and remember again their loss in their new life situation.  It has been suggested that up to 30% of children experience an increase in grief reactions for a time after 9 months.

It can therefore be helpful to expect that your child may need different levels of support at different times, and that there may somewhat unexpectedly be times of more intense grief and a need for support even a number of years after the loss and the initial grief has settled.

It can be helpful to let your child know that this may happen too and that they can come to you and talk about their feelings any time they need to.

Depending on the level of support the young person is needing over time, there may be times that it is helpful to link them in with some additional support, such as a counsellor or mental health professional.

12.  Self care

Supporting our children and young people who have experienced grief and loss is of course a potentially difficult and heart rending task.

It is important to make sure that you have your own support networks around you and that you prioritise your own self-care.  This will be helpful for not only yourself, but your child/young person too – it means you will be able to have the strength that it takes to be there for them while experiencing grief, loss and/or trauma yourself.  It also means you are showing them the importance of taking care of ourselves – and this will be a helpful learning experience they can carry throughout their lives.

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